Psoriasis: causes, risks, and how to manage the flare-ups

Psoriasis

Psoriasis is a chronic inflammatory skin disease of varying intensity: most often mild to moderate, but sometimes particularly severe. The mechanism refers to an accelerated renewal of skin cells. The classic skin symptom is the appearance of well-defined red patches covered with whitish, dry scales. The cause of psoriasis is unknown, although some triggering factors are identified: genetics, immunological disorders, infectious diseases, etc.

As mentioned above, psoriasis is characterized by lesions localized on the scalp, elbows and knees, with involvement of the nails. In severe cases, manifestations extend to the entire skin, and joints can be affected. The disease is said to be autoimmune, that is to say linked to an exacerbated reaction of the immune system against the body’s own tissues.

The psychological and social impact of psoriasis can be very painful for the patient. When the disease is widespread, and involves exposed parts of the skin (the hands in particular), the “gaze of others” is difficult to live with. However, in this context, it should be noted that the condition is not contagious, contrary to what many still believe.

The disease progresses in cycles, with relapses and periods of remission of varying lengths. Effective treatments exist (local, oral, puvatherapy). The first signs usually appear in adolescence, and the condition affects both men and women.

As for the causes, they are not known. A familial predisposition is identified in a third of cases, and a genetic component is therefore probable, as well as the influence of environmental factors.

There are multiple forms of psoriasis:

  • plaque psoriasis: the most common form (80% of cases)
  • guttate psoriasis
  • erythrodermic psoriasis (severe and generalized form)
  • pustular psoriasis

Is psoriasis contagious?

Psoriasis is a non-contagious skin condition. It cannot therefore be transmitted from one person to another. It, however, in part determined by heredity. The likelihood of someone having psoriasis is greater when the disease is present in the family. When both parents and a sibling have psoriasis, the risk of getting the disease yourself can be as high as 80%. When both parents have psoriasis but not the sibling, the risk is only 65%. When only one of the parents and a sibling caught it, the risk drops to 40%. When only one of the parents suffers from psoriasis, the risk is only 28%. And when only a sibling is affected, the risk is reduced to 24%.

Hereditary character therefore clearly influences the risk of actually catching this disease, even if other factors, still partly unknown, may play a role. Conversely, not having a family history is no guarantee of never catching the disease. Triggers can, for example, be skin injuries, pressure points on the skin, mental stress, alcohol, drugs, infectious diseases or even hormonal factors. Researchers are also increasingly considering that there are two types of psoriasis, namely type I and type II psoriasis. Type I are people who develop psoriasis around the age of 20. People who have it between the ages of 40 and 50 fall under type II. Heredity plays a lesser role in type II psoriasis than in type I.

Increased risk of diabetes

Patients with psoriasis are at a considerably higher risk of metabolic syndrome, with the risk of developing type 2 diabetes and suffering from cardiovascular complications according to a study conducted by an Icelandic researcher, who looked at the medical records of 6,500 patients (average age 39 years), included in a large American database. Dr Thorvardur Jon Love observed that 40% of people with psoriasis showed signs of a “complete” metabolic syndrome, compared to only 23% in the control group. The most frequent manifestations of the syndrome are abdominal obesity (63%), high triglyceride levels (44%), and too low levels of HDL (good) cholesterol (34%). While 28% of subjects without psoriasis did not present any of the characteristics of metabolic syndrome, this proportion drops to 13% in the “psoriasis” group.

The author of this research concludes that “these results obtained from a representative sample of adults show a doubling of the prevalence of metabolic syndrome in patients with psoriasis.

Risky situations

Psoriasis flare-ups are unpredictable, as are their severity and duration of remissions. However, certain behaviors and a series of situations seem to favor or worsen crises.

  • tobacco
  • stress
  • tiredness
  • anxiety
  • emotional shock
  • alcohol
  • infections
  • weakened immune system
  • sun burns
  • lesions (wounds) of the skin
  • overweight
  • drugs (beta-blockers, antimalarial, etc.)

It is therefore important to be aware of these risk factors.

How to manage the disease?

The management of psoriasis is based in particular on a healthy lifestyle. Body care, stress management, diet… there are a few things that you can implement in your daily life to combat the flare-ups.

  • Clothing

Synthetic fibers can irritate the skin and prevent it from breathing properly. It is therefore recommended to wear clothes made of natural material, such as linen, cotton or silk, with loose cuts that facilitate perspiration wicking. Comfort should be favored and as much as possible to reduce the possible friction of the fabric on the skin.

  • Skin care

Beyond drug treatment, it is essential to take great care of your skin. Thus, optimal hydration (emollient products) is crucial, by applying a thick layer of cream at the end of a bath or shower. Do not dry the skin by rubbing it with a towel, but do it by patting, and spread the cream on a still slightly damp skin. Your hair should be washed with a mild shampoo that does not irritate the scalp too much.

In this context, your bath or shower water should not be too hot: a temperature above 35 °C may dry out the skin and disrupt its natural acidity, which can cause an outbreak of psoriasis. You should therefore not expose your skin for too long to hot water, as is often the case in a bath. The skin should be washed with an oily soap or a cleansing lotion without perfume and with neutral pH.

  • Professional activities

People with psoriasis can of course exercise any type of profession. In some cases, however, they must take precautions to protect their skin. Heat, exposure to the sun, handling chemicals, poor sanitation conditions–all factors that can be harmful. This also applies to work clothes that irritate the skin.

  • Stress

In everyday life, stressful situations are almost inevitable. Their consequences are damaging for everyone, but in particular for people with psoriasis, since it is a major risk factor for triggering an outbreak.

The management of stress through specific relaxation techniques, or simply through physical and leisure activities, is of enormous importance.

  • Food

There is no definitive link between the onset or exacerbation of psoriasis and any food or group of foods. So you can eat whatever you want as part of a balanced diet, of course. However, we know that alcohol consumption can worsen psoriasis, same for tobacco.

Although it may seem difficult to respect, you should never scratch yourself. For one simple reason: the relief will only be momentary and it will make the inflammation worse. Applying a damp cloth or handkerchief soaked in salt water to the lesion can help soothe the itching while rehydrating the skin.

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